Skip to main content

Advertisement

Log in

Effectiveness of myoinositol for polycystic ovary syndrome: a systematic review and meta-analysis

  • Meta-Analysis
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

To assess the effectiveness and safety of myoinositol for patients with PCOS.

Methods

In this meta-analysis, data from randomized controlled trials are obtained to assess the effects of myoinositol vs. placebo or western medicine in women with PCOS. The study’s registration number is CRD42017064563. The primary outcomes included total testosterone, estradiol (E2) and the homeostatic model assessment (HOMA) of insulin resistance.

Result

Ten trials involving 573 patients were included. The meta-analysis results show that: compared with the control group, myoinositol may improve HOMA index (WMD −0.65; 95% CI −1.02, −0.28; P = 0. 0005) and increase the E2 level (WMD 16.16; 95% CI 2.01, 30.31; P = 0. 03); while there is no enough strong evidence that the myoinositol has an effect on the total testosterone level (WMD −16.11; 95% CI −46.08, 13.86; P = 0. 29).

Conclusion

Based on current evidence, myoinositol may be recommended for the treatment of PCOS with insulin resistance, as well as for improving symptoms caused by decreased estrogen in PCOS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. R. Azziz, K.S. Woods, R. Reyna, T.J. Key, E.S. Knochenhauer, B.O. Yildiz, The prevalence and features of the polycystic ovary syndrome in an unselected population. J. Clin. Endocrinol. Metab. 89, 2745–2749 (2004). https://doi.org/10.1210/jc.2003-032046

    Article  CAS  PubMed  Google Scholar 

  2. Y. Meng, X. Chen, Z. Peng, X. Liu, Y. Sun, S. Dai, Association between high serum homocysteine levels and biochemical characteristics in women with polycystic ovarian syndrome: a systematic review and meta-analysis. PLoS One 11, e0157389 (2016). https://doi.org/10.1371/journal.pone.0157389

    Article  PubMed  PubMed Central  Google Scholar 

  3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group., consensus on diagnostic criteria and long-term healthiest related to polycystic ovary syndrome. Fertil. Steril. 81, 19–25 (2004). https://doi.org/10.1016/j.fertnstert.2003.10.004. Revised 2003

    Google Scholar 

  4. R. Azziz, E. Carmina, D. Dewailly, E. Diamanti-Kandarakis, H.F. Escobar-Morreale, W. Futterweit, O.E. Janssen, R.S. Legro, R.J. Norman, A.E. Taylor, S.F. Witchel, Task force on the phenotype of the polycystic ovary syndrome of the androgen excess PCOS society 2009: The androgen excess and PCOS society criteria for the polycystic ovary syndrome: the complete task force report. Fertil. Steril. 91, 456–488 (2009)

    Article  PubMed  Google Scholar 

  5. R. Azziz, E. Carmina, D. Dewailly, E. Diamanti-Kandarakis, H.F. Escobar-Morreale, W. Futterweit, O.E. Janssen, R.S. Legro, R.J. Norman, A.E. Taylor, S.F. Witchel, Androgen excess society 2006.:, Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J. Clin. Endocrinol. Metab. 91, 4237–4245 (2006)

    Article  CAS  PubMed  Google Scholar 

  6. L.J. Moran, M.L. Misso, R.A. Wild, R.J. Norman, Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum. Reprod. Update 16, 347–363 (2010)

    Article  CAS  PubMed  Google Scholar 

  7. J. Vague, La différentiation sexuelle. Facteur determinant des formes de l’obesité. Presse Med. 55, 339–340 (1947)

    CAS  PubMed  Google Scholar 

  8. A.H. Kissebah, N. Vydelingum, R. Murray, D.J. Evans, A.J. Hartz, R.K. Kalkhoff, P.W. Adams, Relation of body fat distribution to metabolic complications of obesity. J. Clin. Endocrinol. Metab. 54, 254–260 (1982)

    Article  CAS  PubMed  Google Scholar 

  9. M.A. Kirschner, E. Samojlik, M. Drejka, E. Szmal, G. Schneider, N. Ertel, Androgen-estrogen metabolism in women with upper body versus lower body obesity. J. Clin. Endocrinol. Metab. 70, 473–479 (1990)

    Article  CAS  PubMed  Google Scholar 

  10. C.R. Kahn, J.S. Flier, R.S. Bar, J.A. Archer, P. Gorden, M.M. Martin, J. Roth, The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N. Engl. J. Med. 294, 739–745 (1976)

    Article  CAS  PubMed  Google Scholar 

  11. C. Wu, F. Lin, S. Qiu, Z. Jiang, The characterization of obese polycystic ovary syndrome rat model suitable for exercise intervention. PLoS One 9, e99155 (2014). https://doi.org/10.1371/journal.pone.0099155

    Article  PubMed  PubMed Central  Google Scholar 

  12. J.E. Nestler, J.F. Strauss III, Insulin as an effector of human ovarian and adrenal steroid metabolism. Endocrinol. Metab. Clin. N. Am. 20, 807–823 (1991)

    CAS  Google Scholar 

  13. J.C. Marshall, A. Dunaif, Should all women with PCOS be treated for insulin resistance? Fertil. Steril. 97, 18–22 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  14. J.E. Nestler, D. Stovall, N. Akhter, M.J. Iuorno, D.J. Jakubowicz, Strategies for the use of insulin-sensitizing drugs to treat infertility in women with polycystic ovary syndrome. Fertil. Steril. 77, 209–215 (2002)

    Article  PubMed  Google Scholar 

  15. V. De Leo, M.C. Musacchio, G. Morgante, P. Piomboni, F. Petraglia, Metformin treatment is effective in obese teenage girls with PCOS. Hum. Reprod. 21, 2252–2256 (2006)

    Article  PubMed  Google Scholar 

  16. E. Papaleo, V. Unfer, J.P. Baillargeon, F. Fusi, F. Occhi, L. De Santis, Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles: a prospective, controlled, randomized trial. Fertil. Steril. 91, 1750–1754 (2009)

    Article  CAS  PubMed  Google Scholar 

  17. D. Costantino, G. Minozzi, E. Minozzi, C. Guaraldi, Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur. Rev. Med. Pharmacol. Sci. 13, 105–110 (2009)

    CAS  PubMed  Google Scholar 

  18. G. Donà, C. Sabbadin, C. Fiore, M. Bragadin, F.L. Giorgino, E. Ragazzi, G. Clari, L. Bordin, D. Armanini, Inositol administration reduces oxidative stress in erythrocytes of patients with polycystic ovary syndrome. Eur. J. Endocrinol. 166, 703–710 (2012). https://doi.org/10.1530/EJE-11-0840

    Article  PubMed  Google Scholar 

  19. J.J. Deeks, J.P. Higgins, D.G. Altman, in Special Topics in Statistics, ed. by J.P. Higgins, S. Green Cochrane Handbook for Systematic Reviews of Interventions, Chapter 16 (The Cochrane Collaboration, UK, 2011)

  20. J.J. Deeks, J.P. Higgins, D.G. Altman, in Assessing Risk of Bias in Included Studies, ed. by J.P. Higgins, S. Green Cochrane Handbook or Systematic Reviews of Interventions Version 5.1.0, Chapter 8 (The Cochrane Collaboration, UK, 2011)

  21. J.J. Deeks, J.P. Higgins, D.G. Altman, in Analyzing Data and Undertaking Meta-analyses. ed. by J.P. Higgins, S. Green Cochrane Handbook for Systematic Reviews of Interventions, Chapter 9 (The Cochrane Collaboration, UK, 2011)

  22. E. Benelli, S. Del Ghianda, C. Di Cosmo, M. Tonacchera, A combined therapy with Myo-inositol and D-chiro-inositol improves endocrine parameters and insulin resistance in PCOS young overweight women. Int. J. Endocrinol. 2016, 3204083 (2016). https://doi.org/10.1155/2016/3204083

    Article  PubMed  PubMed Central  Google Scholar 

  23. J. Nehra, J. Kaushal, S.R. Singhal, V.S. Gehlaut, A comparative study of myo inositol versus metformin on biochemical profile in polycystic ovarian syndrome in women. Int. J. Pharm. Sci. Res. 8(4), 1664–1670 (2017). https://doi.org/10.13040/IJPSR.0975-8232

    CAS  Google Scholar 

  24. F. Fruzzetti, D. Perini, M. Russo, F. Bucci, A. Gadducci, Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS). Gynecol. Endocrinol. 33, 39–42 (2017)

    Article  CAS  PubMed  Google Scholar 

  25. P.G. Artini, O.M. Di Berardino, F. Papini, A.D. Genazzani, G. Simi, M. Ruggiero, V. Cela, Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol. Endocrinol. 29, 375–379 (2013). https://doi.org/10.3109/09513590.2012.743020

    Article  CAS  PubMed  Google Scholar 

  26. A.D. Genazzani, C. Lanzoni, F. Ricchieri, V.M. Jasonni, Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecol. Endocrinol. 24, 139–144 (2008). https://doi.org/10.1080/09513590801893232

    Article  CAS  PubMed  Google Scholar 

  27. L. Pkhaladze, L. Barbakadze, N. Kvashilava, Myo-Inositol in the treatment of teenagers affected by PCOS. Int. J. Endocrinol. 2016, 1473612 (2016). https://doi.org/10.1155/2016/1473612

    Article  PubMed  PubMed Central  Google Scholar 

  28. S. Gerli, E. Papaleo, A. Ferrari, G.C. Di Renzo, Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur. Rev. Med. Pharmacol. Sci. 11, 347–354 (2007)

    CAS  PubMed  Google Scholar 

  29. S. Gerli, M. Mignosa, G.C. Di Renzo, Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur. Rev. Med. Pharmacol. Sci. 7, 151–159 (2003)

    CAS  PubMed  Google Scholar 

  30. Y. Loke, D. Price, A. Herxheimer, in Adverse Effects. ed. by J.P. Higgins, S. Green Cochrane Handbook for Systematic Reviews of Interventions. Chapter 14. (Wiley, Chichester, UK, 2008)

  31. J.P.A. Ioannidis, S.J.W. Evans, P.C. Gøtzsche et al. Better reporting of harms in randomized trials: an extension of the Consort statement. Ann. Intern. Med. 141, 781–788 (2004)

    Article  PubMed  Google Scholar 

  32. A. Mansour, S. Hosseini, B. Larijani, M.R. Mohajeri-Tehrani, Nutrients as novel therapeutic approaches for metabolic disturbances in polycystic ovary syndrome. EXCLI J. 15, 551–564 (2016). https://doi.org/10.17179/excli2016-422. eCollection 2016

    PubMed  PubMed Central  Google Scholar 

  33. T.T. Chiu, M.S. Rogers, C. Briton-Jones, C. Haines, Effects of myo-inositol on the in-vitro maturation and subsequent development of mouse oocytes. Hum. Reprod. 18, 408–416 (2003)

    Article  CAS  PubMed  Google Scholar 

  34. V. Unfer, G. Carlomagno, E. Papaleo, S. Vailati, M. Candiani, J.P. Baillargeon, Hyperinsulinemia alters myoinositol to d-chiroinositol ratio in the follicular fluid of patients with PCOS. Reprod. Sci. 21, 854–858 (2014)

    Article  CAS  PubMed  Google Scholar 

  35. M.J. Iuorno, D.J. Jakubowicz, J.P. Baillargeon et al. Effects of D-chiro-inositol in lean women with the polycystic ovary syndrome. Endocr. Pract. 8, 417–423 (2002)

    Article  PubMed  Google Scholar 

  36. J.E. Nestler, D.J. Jakubowicz, P. Reamer, R.D. Gunn, G. Allan, Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome. N. Engl. J. Med. 340, 1314–1320 (1999)

    Article  CAS  PubMed  Google Scholar 

  37. J.P. Baillargeon, M.J. Iuorno, T. Apridonidze, J.E. Nestler, Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metab. Syndr. Relat. Disord. 8, 127–136 (2010). https://doi.org/10.1089/met.2009.0052

    Article  CAS  PubMed  Google Scholar 

  38. V. Unfer, J.E. Nestler, Z.A. Kamenov, N. Prapas, F. Facchinetti, Effects of inositol(s) in women with PCOS: A systematic review of randomized controlled trials. Int. J. Endocrinol. 2016, 1849162 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  39. V. Unfer, G. Carlomagno, G. Dante, F. Facchinetti, Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol. Endocrinol. 28, 509–515 (2012). https://doi.org/10.3109/09513590.2011.650660

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

K.Y. and L.Z. contributed equally to this work.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Liuting Zeng.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Liuting Zeng and Kailin Yang are joint first author.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zeng, L., Yang, K. Effectiveness of myoinositol for polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine 59, 30–38 (2018). https://doi.org/10.1007/s12020-017-1442-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-017-1442-y

Keywords

Navigation